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HomeMy WebLinkAboutPermit Electrical 2004-1-9 (2) ;:. :..~225FIFTH STREET:.~., ". \;;;}; ~;:~ V:~';:\;;,~ i<:~." ET~TC~P.E~T APPYCATION. ',." SPRINGFIELD OREG 97477 ,,' .':-' \. .. '.' :; ',," '";." ...~.;(" .,.'. ....:,-q . ',' . .'. -, .. , . .:. ",~:,-, ~:t. ~"".:;:,:;;'. ~.e' -:__ . .... . ''''''.'' . ;;. ..; . ' " ';"". ','" .';: INSPECTIONREQVS:S1:': '726~3~$.~ :,' :t~ ~f.~;:. r;,.: City Joh Numb~r LO'wr"~oo'.'f.~'~O/~' .: '.' '::~0" :/ OFFI Sri-; 7?- $~3 7?.9 Jj;; t.. . ~t;1~ r;;t~~~:~~*} f.k;~;'(~:'," f,:[' }'i, ......,:<:, ;..;t::..~:~t;:,:\.;~;;:::i;.: " ":',:~~1~~:,:"5:'.} . ,.,' ...".,.."......:. ;.: .... "..../;..".... .:1;".'" .,;~ ~'" 3COMPLETEFEESCHEDULEBELO\V:...':""",:, .... 17033.LfL/? 072-00 Items Cost '. --' \q\lO'JIJing ~ .oJ;#ftrJTION .., J) A '~QJ~ili~rt~gM~se r _ D6D I ~f1 TED ovJ"\ur:J1!.rMtffe~~~C':JflftfMfitlOnal 500 COf~ 1) 110 111. 'S 11l?t-t111h~~~, and does n. sq. ft or portion ~ermfls r/re llon-transteratle and expiieo prova\. . if work is not'started within 180 days ap zonIng -0 lch;.,:'::;> of issuance 9rifwork is suspended for odular ..,,';,<;. .... 180 d'YS,)i".. O:~;'O'i2ed Si9n"u,e . ce or Feeder . .'li2I~t'(i;., $ 50.00 .:;;', 2. CONTRACTOR INST ALLA TION ONLY B. Sel'TICeS or Feeders./>~~~:~'l~':, " :1'~~:ii~'~1" . . ,it.:. " .'>.'.' ;;'i, Installation, Alterations :9~ ;:,;::,,; .'~:"":~q.;.t.;;. . . ;;.J ' .. . .. L R Br bh I ,'.',....". ,,,.;,-.,.} -. ...., Electrical' C6kifacto~.i.:~::(.. a am, nc. Reloc'ltion' "i::' '~""\'~!.~:-\':-il:'-> "'\'"",;,~"" ", ~""; . <;:~:!.:::!\'> j>~";,,, " t4,~~. . . ;,;;;:~~~~~~~4:~';:.~/:i.J~I~&ff' 'f.~::>"~~:~~~~~' Address .~;~.'~,t We~~,;.. Q Street,:::yj\;~j::.;'\;... 200 amps or less '..Ld~;r;':i:Tt1~';:;;;'.;<':':;:'~',i:';' :,;\:;$ 63.00' :.:;!" ..:"':.....;....;,.". ...:~.::.;}:.rn.. .. ;.:~~.t:.e;:.f!>'i.;'}; ~,'... /~~.;l~~~~~~~;..7';..T,.:f......,\. '.,~.$'~.:... ',; OM ff' ....w~.,..~. ~~~~:(L.:;.. ,::.~:';'Fi~'~; .r-:{~"r~t~i;!~'s:~, 20] amps to 400'amps>;;i-~;):rr;~1'*,,~..<,'~:(~'i';V$'7).00. ,.,,'.)',:;;; , Spr l\TI(Mf i e'l:d'iip'" 7 4 #,'!;;:rj'fij":io:'" '~':'",,~"';,,;...;< 0 600' . "-i".\'f~:;f~'il;.""'~,,,:,!;> '''. "~"'$''':- _' .,.. . .,,,,~, Clty,:.~..;J~';"; ;;:<,,;;' llOne :,;1..-S>'\"o"':.."'~'-~',,;~':,r . o' '.. 4 I amps to .amps,":~~:Z'!i~w';:~:.:;';':~"'-\~~'~--:' 12).00. .' <,,<:~; . ""<"~-'''''{''''.''\ ~,>,,"'r";>:~~:' '11' )o~.t,,::\,q'~"""~)'~~~l~ ,r'/''" ;' '~';"'f".J"\';;"::;I;~~0",..tk1:~~:.,...."._:~.v'''~ " ''', \: ,.......,1';.... ....."".i:j;"'Xo:-. ",\.!,<",-"'ii('; """""<;)kW'j\;Aj!;>"'.'i::;i''\t;,,'''''' .':-.....601 amps to 1000 altlps":""~";;'~:.. "."':;,.;,\,,, ',""$163 00 ,.,t!'ii.~':' '. :';;\J~:L'F~'~:;J~'I;~.~':... .'~~;~~;':~-;4:':~.'t::_. <~~~':1:;'~~~~1~---:~:-;v~#f;.';< r.:(t:;' "~;",,, ' . :'. ~"'\...'{ ..~. .....; 'tl~~~~~t~6'~,.;,.,~,;. ~~. " :"J" ~" ,), .,.:. '... ,..,~~ "':,. Supervisor;Llcense'NiiIhber 4'9A4SiB;",,~:','f:'" i' ",\:,Over ] 000 amps/Vo1ts....;r. .~~~:{ ~:.~~.~;-;'{~;ln,:r$3J 5. 00 "~.;1;;~~~; ;:~~~..~~~~ ....~.lz:,..:.:': ~:.~:..<;..t~~~~:.:;( .' -:" :.:.-1' '., 'i..,:tl-';.,-<,;....,,., ~," 1- ' .~',:::. '.'J.;",. . ";~. :..,1,;..... ,.Y,. ".~':"IVJ;;" ' . ..:~:.,;:'~'~;:f:~t~ ',.<'" .i'!~'~1~ ..~.~ . v;'. :":'.'.~ ''''':~l-'~'-' . r.rt:,,~:;~\';~Iti~;\~~,.::}~~A\~~..~l~. :..:>~:frB~~~,:~:ii;.~. b. ~'., ,;i~>R.,~cQn~e<;:.(.,QpJyt{ :,ltb:t~~~{i_"f;~~:?~f.-~S.:$.:~;:~.9.9.D.,:: tW1;:::."~' .", ,.' ""..,.' ''''''i1i'':U:t~,v, 'j./",,'+ii'~"t """.O'''~'' .,....",.... "",.,' . \"., ". ",,"" "'." ""-'1 .........;".., ".'.., '.. rliu ~. ';~'~~I,';.;, Ex,P~E~li~~J?;~,~~:~,':','.';~;(.;~~,i.~~: ~<<,~~:'~.\~~ .: " "~.~}~i!:~~;~~i;,;~1h1~i~~~~~~:;t,,~~;0t~~i~"j~4i~; .~.!'~ ,;0",' ~~: 'J'~'~:":,:', \;.J ',y 1A;' '7:::\~~:'.rfi?{~;~~~~'T/~~)1~~i~,fU~,: ~:.i'~:bt4"ll;ti~;1'J.r.,:,;:~(t~'n~~\.~~:::~t.: . :'!':1"l eru''''''})'o' rfli.v' . 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I , ~. .'.... _M:~' '..,>;:':.~. i' ._ ,"!'""."~ , ,t~r:f:f;':':'" "" . ''"'''''':1;;ir~l;v.''~''8' ':'ifj:' /r..~i'!t' ':!i?i'Jj~ ~"':.,'(:~~\.f:> y:!.~:.'t,,!j;'~"t.,~.~. ~""" .. ~. "1' :vl 1'''' 'I' ",,'; .l....~.l \;':1;' . "'\J~A ~~':'\'" 'Of",' .1....... ':' &~,~ . .l:~~ ,.... :~~2:f'\~~'#.~{~;i=:Expiration Date -. ,..",-..:.f:.,)~';:';,i,,:~):.,. ~;.~\~ .".,...,.,P9.Cl~~~'., I~'\. ,<,I:' __ . '.. ,,~~~ii", .~:\ ; ,\,... ,,;.,;,~,~.,.,F..:> ,'.s.. '<-<-;')"';i!i i> ~{;..; ~""20 1 ,t;i:n~li\kia ri'~' ~ '~~>""~\',e;~~15~': 1."~'""''I'.j:, ~/~;~.;~~~'~ <::f,~i~~~~'\,:~ ~~'.~.;,. . . . . \. '':''l,!~. t~~~:f~.' .\ ~~"~' ~ .~Ij;;(~,;~t,~.,~ :~~~~}r;\~: ?:~..~\ iD1,~~-.~~,I~; \;:~~;';",~~~~\;f'li.~r::Slgllatlirc ~f SUIlcrnslIIg ElectncJaIl ""-.. -~. Over \~(U}~~ .~lllDSt~;: \., J, :'S'~':~"'ti:1it~"t,~00" ~\~lurln '., ,.~,.<l'"')!;"". ....."..:."...,./.,., . ~,. "''''1(\~1<''M~~'"~!(:''!;''~''''''''>''''I"....~V''f~~!:: .' ;..:' "';"'!,Z;'" .\,..' ;,:;....,. ,:"i.'.~:.;..,,:... 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'f~ :.:....:',' .:"'~ ..,flt-., ,~.~, ~ ~ n. ~:. ';"'" I ro-...... ",;;'<,~,~:", ,_..::~;,,'.....:,;.':.~..'t5-'\:f:":. ~(':'" ,::..':.-;;"....;..c~.'.i.':---q:,.:i, . <;,.:~, "'tJ":Cr1i'"PJ''' ",'., """'. ' m't - . D, '.01 anch 'AI CUlts . 'u ':>"';'''''11'''''\':'k~' '.:~;:.. . ,r,"-,,! . .w""'. ,',,{ ,."i;.'....~..~~.. ~~'" .... ~ t' " .,' , . . ""f'''~. "'i!.' ~,~ ,"<(.", .:J; . <'-._.....r, );':: ~~~;~~;{:O,vJiers'Nam ~ ".' 'J'.' ,< . . : ,'" ' New Alteration or Extension Per Pane} '/.?;'!:~;:;. ';::' .' <~::..'~' }{-~;~.:}~:;:{?,:fi;:.!;~'iA.~t!ijr:"':~~~iit .",:.;/ ~ :,'>;', I;;' 7/1('f:J '. : ./". ~,\~ :,.~"})f4~:~~~1'.:':::'C )~~j,~<--- r-li:~":/F:;)':':">AdJ}~s'''':.... iii..>fij;?,i5h:ifjii.i:,:'" ,"., 1 VVI I One ci~~ui't:~. i:-:~' :C~51~:tf$43 00' ..~F\J,t~~ ':.:.:~{;::'::'~i{~;j;K'~"{k:'~"),:i": "';';:":}j.u.~:~,i.ji;;.>.<jt'il --:' 1 J . '. ')'~~:;':~ . ..... ~;.(;.:;i,;~~,Si:.".',;,:J;~~r' . ::: '.).t!)3:r'bj~ <:" t.f11""~.1::.~ o~i,:'t.~~'1~.1 4- 7q 'i Each'Ad~iltf~na.] C~r~~lit or with SeF}.i~;%\'::';': .";';F/' '.' . ........' ". .... ". . .... .' ....H . or Feeder Pernut . . . '$ 300 ,,' ..... ....:~f:'dw~;ER i~STALLi;ION<:;"": . ..< :'::;:. . . '..... The installation is being inade ~~,.,' r\E. ~0fi~ccllancous (Scn'ice/fe~dcr not included) . , , . property I o\'~n '~~~liis.?ot intended~?\\\E. W \ S ~O\ .Eacl~ in~ta.llat~on '. " _ . for sale, 1eal~l9r'lien~' ~\\ S\1~Ll E \\\S ?E.\\~\1 \ \\ Pump or IrngatlOn' . . $)0,00 ,r\\S ?b\\ . \j~\)tR.\ . O~E.IJ rO Sign/Outline Lighting $50.00 OWllers Sign:I~.\,\O\\\lEO O~ \S ~~~~IJ Limited Energy/Res $25.00 ~OW\N\t.~CED ?ER\Oo... . Limited Energy/Comm -'" $45.00 . "\~QO~'{ . .' ~ I\N' l\'linimum Electric Pel'mit Inspcction Fce is 545.00 + ),urchargcs . . .' . '.. 4, SUBTOTAL OF ABOVE \~_. ." .. -----'1.3 I - '15 7% State SUl'charge J$ ~ 3/-> }O~/o Administrativc Fec 4' I.( so ~ .. ,.':. '.'. ~ .-, . '; :: . ~ ". .... '.;.:... . '. <:~:: . ...,......... ..}~.::..:.... if I '4i~/ ~~:~t:~{~:...,.. .:~.~~;~.:~..', '. " :., ';":",' . . .' ".,::. . . . '... ,~. ~::.',> './ '.:::::.~~:,: . .::', :~,~::~,: l ' . '. '''~~', .' .' .- . . ..,' ,..~ . '. .~, ~ .. , .: ' , .11 . ~ "'. ..,...'. . ,:,'.;.. '".:.::. ,.",;,,' .... ,'. ..~: 't. .. . '-".l,-.' "':.. . . ;~':' '~,.' '.. ; ,rc:.0. su#i;;" ..:,-:"', ..";".:... $106.00 ....:.., ,. :,..';.:; ",..... " , . :,,;.;J;:.~.,. $ 19.00 ...< ,,". TOTAL '. . . CITY OF SPRINGFIELD " Building/Combination Permit , PERMIT NO: COM2004-00014 ISSUED: 01105/2004 APPLIED: 01105/2004 EXPIRES: 07/05/2004 VALUE: Status Issued 225 Fifth-Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1510 CONCORD AVE ASSESSOR'S PARCEL NO.: 1703344307200 Eugene TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: 20 amp circuit for phone system Owner: DOUG CLARK Address: 346 N GRAND ST EUGENE OR 97402 Phone Number: 541-34~-4794 I CONTRACTOR INFORMATION .. 'J' Contractor Type Electrical Contractor LR BRABHAM License 8699 BUILDING INFORMATION. Expiration Date 12/18/2004 Phone 541-747-6638 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Storie's: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: , SETBACKS I DEVELOPMENT INFORMATI~ requIreS you to ATTENT\ON:oreg db the Oregon U~UIRED PARKING OY'aft~-RiftJ\eS adopte h:Se rules are seqf8i~: # Sfb,MeamrRqtnnter. ~ through OAR 952ffilRdicapped: paY\ee,1l~v9~~P~t-~~01 ih\copies of the ru~'Pact: % 90l36t.0'cWt!r:\IgtY obta Note: the te\ephO~e ' , calling the center. ( n Utl\ity NotificatIon , . 'b...... fnr 'he Orego . __ fl'l" A) . .u;V;e - . :1_)'(llIl-.-:o~-,,- ~ - , I PUBLIC IMPROVEN>ml'''l 1 S I' , , Sidewalk Type: Downspouts/Drains: '. Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction ' $ Per Sq Ft or multiplier NOTICE: Valuation Descri ~ni5 ERMIT SHALL EXPIRE IF THE WORK J n RilED UNDER THIS PERMIT IS NOT Sq~~~~~C&D OR IS ABANDONED f()Q o~ A1&QJJt'\Y PERIOD~alue D'a'te Calculated Total Value of Project Paeelof2 ....;..~~,e'.~eJ;I@~\ "_~,,..,,_ . \ ~ i f , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid . Fees Paid I Amount Paid $4.50 $3.15 $43.00 $2.00 $52.65 Plan Reviews I Date Paid 1/5/04 1/5/04 1/5/04 1/5/04 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00014 ISSUED: 01105/2004 APPLIED: 01105/2004 EXPIRES: 07/05/2004 VALUE: Receipt Number 1200400000000000009 1200400000000000009 1200400000000000009 1200400000000000009 To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reauired Injpections . 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any struCture without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at ail times during construction. Owner or Contractors Signature . ~, Pal!e 2 of 2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~ Job/Journal Number COM2004-000 14 COM2004-000 14 COM2004-000 14 COM2004-000 14 Payments: Type of Payment , Check Check Job/Journal Number COM2004-00014 COM2004-00014 COM2004-000 14 COM2004-000 14 Payments: Type of Payment , Check Check ,r @~~~~_q;_"~,"U" ~(_.. _'____T..'.~_'_n.___.< ~~..~._..__..... ~"""__,,^_,;,_,,,:,~,.'..,~ r ,r Receipt #: 1200400000000000009 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum! Adjustment Electrical Paid By LRBRABHAM LR BRABHAM Received By djb djb Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum! Adjustment Electrical Paid By LR BRABHAM LR BRABHAM Received By djb djb Check Number Batch Number Authorization Number Check Number Batch Number Authorization Number . City of Springfield Official Receipt;... Development Services Depa.l&Uent Public Works Department" . Date: 01/05/2004 2:52:59PM Amount Paid 3.15 4.50 43.00 2.00 $52.65 Item Total: How Received In Person In Person Payment Total: Amount Paid $2.34 $50.31 $52.65 Amount Paid . Item Total: 3.15 4.50 43.00 2.00 $52.65 How Received In Person In Person Payment Total: Amount Paid $2.34 $50.31 $52.65 .